Despite widespread national attention, the opioid epidemic and larger problems of substance use and misuse continue to deeply affect communities across Pennsylvania and throughout the nation. The impact of the opioid crisis and other substance abuse problems hits even harder for people grappling the criminal justice system, who are 12 times more likely to have substance use disorders (SUDs) than those among the general population.
Beginning in January 2020, a new, two-year $91,000 grant from the National Institute of Justice (NIJ) will fund a Penn State-led project called “The Experiences of Men with Substance Use Disorders Exiting Prison at the Height of the Opioid Crisis.” The project aims to understand the post-prison trajectories of men with SUDs while evaluating the trends and common challenges of reentry. The funding will support the project’s principle investigator and an undergraduate research assistant in the coding and analysis of in-depth qualitative interviews with inmates, and with the cleaning and analysis of statewide quantitative data.
According to Kimberly Davidson, doctoral student of criminology and principal investigator of the project, tracking the post-prison paths of men with SUDs will better highlight the changes needed within and outside the prison system to support inmates with SUDs. The project will also leverage partnerships with Pennsylvania’s Department of Corrections (PADOC) and Commission on Sentencing (PCS) to analyze the post-release outcomes of three statewide inmate reentry cohorts. These quantitative analyses will illustrate how reentry has been impacted by the shifting landscape of the opioid crisis, in addition to contextualizing the experiences of the 88 men in the interview sample within aggregate statewide trends.
Much of Davidson’s work focuses on the need for high-quality, substance abuse programming like a "Therapeutic Community" (TC), which many correctional institutions have already incorporated. TCs are a group-based, drug and alcohol treatment program that have demonstrated evidence of effectiveness in lowering rates of relapse and recidivism.
She explained that, “There are some issues that make it more difficult for inmates with SUDs to truly engage with the recovery process while in prison. For example, the Pennsylvania Department of Corrections has 4-month long prison-based TC programs, but the TC model used in other inpatient settings calls for 12 to 18 months of treatment. Prison norms, like masculinity and invulnerability, also counter the structure and culture of TC programs, which are group-oriented and rely on peer influence and feedback to help in the recovery process.”
Davidson began interviewing inmates with histories of SUDs prior to their release from a Pennsylvania state prison in December 2016. The pre-release interviews focused on a respondent’s childhood experiences, personal history with substance use and criminal behavior, prior treatment experiences, and plans for reentry. Davidson noted that many respondents expressed hopefulness for their futures following their reentry.
“There’s evidence that children and work are anchored to sobriety. Many of the men I interviewed said they wanted to focus on staying sober for their children and providing for their families,” Davidson noted.
When it came time to complete the follow-up interviews, Davidson focused on the men’s experiences since their release from prison. The expected challenges of reentry permeated the post-release interviews, like housing, employment, family reunification, parenting, transportation, health, stigma, and re-acclimating to life outside of prison. However, in addition to those issues, the challenges of sobriety compounded the trials of reentry. Many of the men often had family or friends who actively used drugs or alcohol, while some men had environmental or behavioral “triggers” present that caused them to use. For many, there was difficulty simply coping with the many challenges of reentry without turning to substances.
“During the post-release interviews, I found that many men with SUDs struggle substantially during the months post-release, with many of them relapsing, violating their parole, and being reincarcerated. The men who do manage to stay sober often end up living a life of self-imposed isolation to ensure they do not relapse. This also relates to the issue of the harsh surveillance of parole itself, of being under supervision, which criminalizes normal pathways of recovery.” About one-third of the “post-release” interviews took place in a state prison, as a substantial portion of the men interviewed were incarcerated for violations of parole during the data collection timeframe.
Building upon multiple prison-related research projects like the Prison Inmate Network Study (PINS) started by Derek Kreager, professor of sociology and criminology and director of the Criminal Justice Research Center at Penn State, Davidson says she wanted to work with the prison population after completing a practicum placement in a county jail while doing her undergraduate degree in music therapy. For Davidson, Kreager’s work in correctional institutions, and especially his research involving prison-based TCs, motivated her to pursue a graduate career at Penn State and engage in research to help the thousands of inmates struggling with SUDs. Ultimately, Davidson hopes the project will inform policy changes surrounding reentry, parole, prison-based and community drug and alcohol treatment, and community corrections.
“I feel privileged and honored to tell the stories and the truths of these men," said Davidson. "They spoke so openly with me about the worst experiences and moments of their lives, but they also shared their hopes and dreams of staying sober, finding a good job and rebuilding their future, with me. I hope that this project and any other research afterwards will shed light on when and how reentry planning collapses, the impact of continuity of care through aftercare, the circumstances surrounding relapses and recidivism, and what protective factors strengthen pathways of desistence and recovery.”